CHFM Practice Exam Questions with Answers Certified Health Care Facility Manager (CHFM) Certification

NFPA 80 (Standard for Fire Doors and Other Opening Protectives) sets requirements for fire door construction and installation. It specifies that the maximum undercut clearance is 3/4 inch unless otherwise tested and listed. Greater clearances compromise the integrity of the fire barrier.

“WAGD” stands for Waste Anesthetic Gas Disposal. These outlets are installed in operating rooms to remove excess anesthetic gases exhaled by patients or escaping from anesthesia equipment. The purpose is to maintain staff safety and compliance with NFPA 99 (Health Care Facilities Code), which requires WAGD systems in anesthetizing locations.

Correct (D): Operating rooms require WAGD outlets as part of medical gas and vacuum systems.

Incorrect:

A. boiler room: No patient care; WAGD outlets are not relevant.

B. electrical closet: For electrical equipment only, no medical gases.

C. laundry room: Handles linens, not anesthetic gas removal.

Under the ADA Accessibility Guidelines (ADAAG), room identification signs must include raised tactile characters and Braille. These apply to permanent spaces such as patient rooms, restrooms, and offices.

C. room identification (Correct): Required by ADA to have tactile and Braille.

A. directional: May use visual characters only; Braille is not required.

B. informational: Same as directional, not required to have Braille.

D. mechanical spaces: These areas are typically staff-only; signs do not require tactile or Braille by ADA standards.

OSHA’s Control of Hazardous Energy (Lockout/Tagout) Standard (29 CFR 1910.147) requires that employers implement a staff training program to ensure all affected employees understand energy control procedures. Insulated tools, logs, or clothing may be used in some contexts, but training is mandatory under OSHA.

CMS Condition of Participation 482.41(c)(2) requires hospitals to ensure that elevator equipment is routinely inspected, tested, and maintained. Appendix A to this regulation clarifies that documentation of these three elements demonstrates compliance.

Correct (C): Maintenance – Inspections and testing alone are insufficient; ongoing maintenance must be documented.

Incorrect:

A. recalls: Not part of CMS 482.41(c)(2).

B. cleaning: While important, cleaning is not listed as a compliance requirement.

D. repairs: Only performed when problems are found; maintenance is the proactive required element.

EPA and OSHA define regulated medical waste (RMW) as waste that is saturated or dripping with blood or other potentially infectious materials (OPIM).

B. Blood-saturated gauze (Correct): Meets the definition of RMW.

A. Fluorescent bulbs: Considered hazardous universal waste (mercury), not RMW.

C. Urine-soaked pads: Not classified as RMW unless visibly contaminated with blood.

D. Home-use sharps: Not regulated by EPA as medical waste from households.

Leadership requires a business case to justify capital expenditures. The Return on Investment (ROI) demonstrates cost savings, efficiency, and risk reduction benefits of replacing the boiler, making it the most critical piece of information. Size, maintenance cost, or timeline support the request, but ROI is decisive for approval.

In a standard patient room in a healthcare facility, the typical medical gas outlets include:

Oxygen (1) – for patient respiratory therapy.

Medical Air (2) – used for respiratory support.

Vacuum (4) – for suction applications.

Nitrogen (3) is not normally supplied in a patient room; it is typically used in surgical suites for powering tools.

Step 1: Calculate utility cost per square foot.

$1,200,000 ÷ 500,000 sq. ft. = $2.40 per sq. ft.

Step 2: Calculate new total square footage.

500,000 + 100,000 = 600,000 sq. ft.

Step 3: Projected utility cost.

600,000 × $2.40 = $1,440,000

Thus, the anticipated utility budget after expansion is $1,440,000.

The correct calculation shows an annual energy consumption of 158,444 kWh. Smaller values (A and B) underestimate by factor of 10, while D overestimates by factor of 100.

In a primary-secondary chilled water system, the primary loop is constant volume, supplying chilled water from the chiller plant. The secondary loop uses variable volume pumping to match distribution system load demand efficiently.

A. Secondary loop (Correct): Where variable flow is applied.

B. Open loop: Not a recognized term in this context.

C. Primary loop: Constant flow design.

D. Cooling tower loop: Separate condenser water system, not chilled water distribution.

The outsourcing scenario matches the current in-house budget exactly; therefore, no savings are achieved. This type of financial analysis is common in the CHFM Financial Management domain.

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Hospitals must have a Type 1 Essential Electrical System (EES) as required by NFPA 99. Type 1 systems provide at least two separate branches: the Life Safety branch and the Critical branch, ensuring continuous power to essential life support, patient care, and safety functions during utility outages.

Type 2 systems (for smaller facilities) have fewer requirements.

Type A and B are not classifications under NFPA 99.

When fire protection systems (sprinklers, alarms) are impaired during construction, Interim Life Safety Measures (ILSM) must be implemented to maintain safety. These include fire watch, additional training, and temporary compensating measures.

B. ILSM (Correct): Required under TJC and NFPA 101 during impairments.

A. ICRA (Infection Control Risk Assessment): Applies to infection risk during construction, not fire protection.

C. PASS (Pull, Aim, Squeeze, Sweep): Fire extinguisher operation technique.

D. RACE (Rescue, Alarm, Contain, Extinguish): Emergency fire response procedure.

The Joint Commission (TJC) requires hospitals to conduct environmental tours (also called Environment of Care rounds) with the primary purpose of identifying hazards to patients, staff, and visitors. While compliance, risk categorization, and system failures may be evaluated, the main focus is proactive hazard identification to reduce safety risks.

MRI does not use ionizing radiation, so radiation-related injuries are not possible. The greatest risk is the “missile effect” where ferromagnetic objects (scissors, oxygen tanks, tools) are violently pulled into the MRI bore by its powerful magnetic field.

D. Missile projection (Correct): Most likely injury hazard.

A. Visual impairment: Not a typical MRI injury.

B. Radiation overexposure: MRI uses magnetic fields, not radiation.

C. Hearing loss: Possible from loud noise but mitigated with ear protection; less common than missile hazard.

The Joint Commission Emergency Management Standards require organizations to evaluate their capabilities and plan for how they would maintain operations during an emergency for up to 96 hours. This does not mandate stockpiling or guaranteeing resources for that duration, but rather ensuring that the facility has assessed its resources, strategies, and agreements to maintain patient care and safety during prolonged emergency conditions.

Incorrect Options:

A and B: Maintaining actual supplies/utilities for 96 hours is not specifically required.

C: Agreements with vendors may be part of the plan but are not the mandated standard.

CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities (1994, reaffirmed in later updates) require negative pressure isolation rooms as a primary engineering control. This ensures airflow moves into the room and is exhausted to the outside or through HEPA filtration. PPE and respirator fit testing are administrative or personal controls, not engineering.

OSHA’s Control of Hazardous Energy (Lockout/Tagout) standard, 29 CFR 1910.147, requires that each authorized employee shall affix a personal lockout device to the energy-isolating device when they are working on equipment. This ensures that energy cannot be restored until every individual has removed their own lock, thereby directly protecting each worker.

Correct (D): The standard explicitly describes the use of a multiple lockout device (commonly called a hasp), where each employee applies their own personal lock. No lock may be removed until the individual’s work is complete.

Incorrect Options:

A: Listing multiple names on a single lock/tag does not meet OSHA’s requirement for individual control.

B: Providing multiple keys to a single lock defeats the purpose of individual energy control and is not compliant.

C: Commonly keyed locks are prohibited because one employee could remove another’s lock.

Relevance to CHFM Exam (Compliance Domain):

The CHFM exam tests knowledge of OSHA workplace safety standards because healthcare facility managers must ensure compliance in utility and maintenance operations. Proper lockout/tagout procedures are critical for worker safety and regulatory adherence.

Per the AIA General Conditions of the Contract for Construction (AIA Document A201), the architect reviews and approves shop drawings, product data, and samples for compliance with design intent and contract documents. The contractor ensures submission and coordination, but final approval authority rests with the architect.

Acceptable indoor CO? concentrations in healthcare facilities are generally expected to remain below 1,000 ppm, as recommended by ASHRAE Standard 62.1 (Ventilation for Acceptable Indoor Air Quality). A reading of 1,500 ppm typically signals inadequate ventilation and insufficient outside air being introduced into the space. This is a direct indicator of poor dilution of indoor contaminants.

Correct: Lack of outside air (C) – High CO? concentrations are directly linked to reduced outside air supply.

Incorrect:

A. Within design – Not correct, since 1,500 ppm exceeds design thresholds.

B. Vehicular exhaust – Would raise CO and NOx levels, not primarily CO?.

D. Humidity/dewpoint – Unrelated to CO? measurement.

To evaluate overall building condition, the Facility Condition Index (FCI) is commonly used. FCI = Deferred Maintenance ÷ Current Replacement Value. A lower FCI indicates better building condition (less deferred maintenance relative to value).

Building 1: 1,200,000 ÷ 25,000,000 = 0.048

Building 2: 200,000 ÷ 2,500,000 = 0.080

Building 3: 25,000 ÷ 600,000 = 0.0417

Building 4: 900,000 ÷ 10,000,000 = 0.090

Building 3 has the lowest FCI (0.0417), which means it has the least deferred maintenance compared to its value and therefore is in the best overall condition.

Incorrect Options:

Building 1 (0.048) – Good, but not the lowest.

Building 2 (0.080) – Higher FCI means poorer condition.

Building 4 (0.090) – Highest FCI of the group.

Benchmarking is the structured process of setting a reference standard (internal or external) and comparing an organization’s processes, outputs, or outcomes against that standard to identify performance gaps and opportunities for improvement. In CHFM practice, benchmarking supports administrative decision-making for staffing, service levels, utility performance, and cost metrics by aligning results to recognized peer or industry standards.

Comprehensive and Detailed Explanation From Exact Extract:

Symptoms such as nausea, dizziness, headaches, and drowsiness are commonly associated with poor indoor air quality (IAQ). The most likely cause in this case is insufficient outside air ventilation, which allows buildup of carbon dioxide and other indoor contaminants.

Correct Answer (C. insufficient outside air): According to ASHRAE Standard 62.1 (Ventilation for Acceptable Indoor Air Quality) and referenced in NFPA 99 Health Care Facilities Code, inadequate outside air results in occupant discomfort and health complaints known as “sick building syndrome.”

Incorrect Options:

A. mercury spill: Causes more acute, localized toxic exposure symptoms; less likely across an entire wing unless a large spill occurred (and it would be unusual in general occupancy areas).

B. humidity levels: Low or high humidity can cause discomfort, but not typically dizziness or drowsiness.

D. medical gas leak: Could cause similar symptoms depending on the gas, but would typically trigger alarms and affect specific zones tied to gas lines, not general wing-wide complaints.

Relevance to CHFM:

This question relates to the Compliance and Maintenance & Operations domains. CHFM professionals must ensure compliance with ventilation codes (ASHRAE 62.1, NFPA 99, Joint Commission EC standards) and manage HVAC systems to maintain proper indoor air quality, protecting patient and staff health.

Any renovation project in a healthcare environment—even in non-clinical spaces like a dietitian’s office—requires evaluation of infection control and safety hazards. The Infection Control Risk Assessment (ICRA) process, supported by The Joint Commission and Facility Guidelines Institute (FGI) standards, mandates involvement of infection prevention and safety personnel in planning.

Correct (D): Ensures compliance with infection prevention standards and staff/patient safety during renovation.

Incorrect:

A. housekeeping and security: Important for support but not primary coordinators.

B. interior designer and supply chain: Handle design and material procurement, but not regulatory compliance.

C. information technologies and finance: Important in certain projects, but not relevant for infection/safety planning.

In healthcare facility maintenance, institutional standards are established to improve consistency, reliability, and efficiency in operations. Ball valves are often chosen over gate valves because they are available in standardized sizes, have fewer variations, and simplify inventory management. This allows facility departments to reduce the number of spare parts stocked and streamline repairs. The CHFM exam reference materials, including ASHE/AHA guidelines, highlight that “ease of inventory control and standardization” is a common justification for selecting one type of valve as a facility standard.

According to NFPA 72: National Fire Alarm and Signaling Code, the following frequencies apply:

Waterflow devices (D): Must be tested quarterly.

Supervisory signal devices: Semiannual testing.

Duct detectors and door holders: Tested annually.

Thus, only water flow devices require quarterly testing.